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Does surgical site infection influence neurological outcome and survival in patients undergoing surgery for

N A Quraishi1, M S Ahmed2, G Arealis2

  • 1Centre for Spinal Studies and Surgery, Queens Medical Centre Campus, Nottingham University Hospitals NHS Trust, West Block, D Floor, Derby Road, Nottingham, NG7 2UH, UK. nasquraishi@hotmail.com.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
|October 29, 2018
PubMed
Abstract

Insights

Surgical site infections (SSIs) in patients with metastatic spinal cord compression (MSCC) increase hospital stay and need for procedures. While SSIs do not impact neurological outcome, they significantly reduce patient survival.

Area of Science:

  • Oncology
  • Neurosurgery
  • Infectious Diseases

Background:

  • Surgical site infections (SSIs) are a known complication after spinal surgery.
  • Literature primarily focuses on SSI incidence and risk factors, with limited data on its impact on neurological outcomes and survival in metastatic spinal cord compression (MSCC).

Purpose of the Study:

  • To determine if SSIs adversely affect neurological outcome and survival in patients undergoing emergent surgery for MSCC.

Main Methods:

  • Retrospective review of 318 consecutive patients undergoing surgery for MSCC between October 2005 and October 2012.
  • Analysis of morbidity (neurological outcome, hospital stay, additional procedures) and survival rates in infected versus non-infected groups.

Main Results:

  • The incidence of SSIs was 9.1% (29/318 patients).
  • Infected patients had significantly longer hospital stays (median 25 vs. 13 days, p=0.001) and required more additional procedures (69% vs. 3%, p=0.001).
  • No significant difference in neurological outcome was observed (p=0.37), but survival was significantly shorter in the infected group (median 131 vs. 258 days, p=0.03).

Conclusions:

  • SSIs significantly increase morbidity, including prolonged hospital stay and the need for re-operation.
  • Despite no impact on neurological recovery, SSIs are associated with a statistically significant reduction in survival for MSCC patients.
Keywords:
Metastatic spinal cord compressionSpinal metastasesSurgical site infection

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